TRAUMATIC BRAIN INJURY Methods for Clinical and Forensic Neuropsychiatric Assessment - Robert Granacher, ...

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T
RAUMATIC
B
RAIN
I
NJURY
Methods for Clinical and Forensic
R
OBERT
P. G
RANACHER
CRC PRESS
Boca Raton London New York Washington, D.C.
©2003 CRC Press LLC
Neuropsychiatric Assessment
Library of Congress Cataloging-in-Publication Data
Granacher, Robert P., 1941-
Traumatic brain injury : methods for clinical and forensic neuropsychiatric assessment /
Robert P. Granacher, Jr.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-8493-1429-1 (alk. paper)
1. Brain damage—Diagnosis. I. Title.
[DNLM: 1. Brain Injuries—complications. 2. Brain Injuries—diagnosis. 3. Expert
Testimony. 4. Forensic Psychiatry—methods. 5. Neuropsychological Tests. WL 354 G748t 2003]
RC387.5.G73 2003
616.8'0475—dc21
2003046073
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Preface
Approximately 2 million traumatic head injuries occur in the U.S. yearly. These in turn produce
more than 50,000 deaths annually. There is a biphasic distribution of brain injury, with the highest
incidence found among young people 15 to 24 years of age and a second group of citizens greater
than 75 years of age. Almost 25% of head injuries require hospitalization, and nearly 100,000
persons yearly are left with some level of chronic brain impairment.
This text has a specific focus. It provides not only methods for clinical examination but also
the forensic evaluation of traumatically brain-injured persons. The reader can be selective in using
this book. If he or she is interested only in clinical assessment, treatment planning, and neuropsy-
chiatric treatment, the first eight chapters of the book will suffice. On the other hand, for the
physician performing a forensic neuropsychiatric examination, the entire book should be useful. If
the clinician is already highly skilled in the clinical evaluation of traumatic brain injury but wishes
to learn further forensic issues, he or she may focus only on the last four chapters of this text.
There is a simple logic to the book. It follows traditional medical evaluation concepts with a
neuropsychiatric focus. It demarcates differences in the adult evaluation vs. the child evaluation.
Chapter 8
integrates the clinical section of this text, whereas
Chapter 11
integrates the forensic
section of the text. The seven preceding chapters in the clinical section of the book proceed logically
to a culmination of data analysis and case studies in
Chapter 8
. The same format applies to the
forensic section,
Chapters 9
to
12
.
Chapters 9
to
11
provide the forensic analysis database, and
Chapter 12
offers the forensic expert guidance for the writing of neuropsychiatric traumatic brain
injury reports and the providing of neuropsychiatric testimony.
This text is not intended to provide complete information regarding the multiple advances
within the entire field of traumatic brain injury. For instance, it provides only a limited focus on
management of acute traumatic brain injury. This is better left to neurosurgeons and trauma
physicians. Its primary intent is to provide the physician, at some time well after the brain injury,
with a clinically tested schema for either evaluating and treating a patient or examining a plaintiff
or defendant. The genesis for this text comes from the author’s database of almost 3000 traumatically
brain-injured persons, or those alleging a traumatic brain injury, examined by extensive historical,
physical, imaging, neuropsychological, and laboratory procedures. It is hoped that the reader will
find this to be a practical text providing pragmatic information either for evaluation and treatment
of one’s patient or for providing a state-of-the-art forensic examination of an alleged traumatic
brain injury.
©2003 CRC Press LLC
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